Urinalysis (automated, with microscopy)
Facility: Mercy Specialty Hospital Southeast Kansas
Billing Code: 81001 (CPT)
- CPT Billing Code: 81001
- Insurance Median: $6
- Cash Discount Price: $72
- vs. Medicare Baseline: 1.89x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Understanding this gauge: We use the federal Medicare rate of $3.17 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Globalhealth Contracted [320145] | $3 | 95% |
| Medical Associates Health Contracted [320444] | $3 | 95% |
| UnitedHealthcare | $3 - $102 | 95% |
| Humana | $3 | 95% |
| Blue Cross Blue Shield | $3 - $7 | 95% |
| Medicaid / KanCare | $3 - $5 | 95% |
| Halo Hcr Inc Hospice [20432] | $3 | 95% |
| Cigna | $3 - $18 | 95% |
| Medicare (plans) | $3 | 95% |
| Cherokee Nation Health Serv Contracted [320066] | $3 | 95% |
| Medica Contracted [320239] | $3 | 95% |
| Tricare | $3 | 95% |
| Halo Hcr Inc Hospice Contracted [320432] | $3 | 95% |
| Mercy Mgd Behavioral Health Contracted [320259] | $3 | 95% |
| Cross Timbers Hospice [20098] | $3 | 95% |
| Qual Choice Contracted [320325] | $3 | 95% |
| Aetna | $3 | 95% |
| United Medical Resources Contracted [320454] | $3 - $9 | 95% |
| Provider Partners Health Plans Contracted [320450] | $3 | 95% |
| First Health Contracted [320128] | $3 | 95% |
| Kindful Hospice [20434] | $3 | 95% |
| Elara Caring Aspire Hospice [20433] | $3 | 95% |
| Mercy Hospice Okc [20252] | $3 | 95% |
| Pace Of The Ozarks Contracted [320518] | $3 | 95% |
| Kindful Hospice Contracted [320434] | $3 | 95% |
| Dept Of Veteran Affairs Contracted [320106] | $3 | 95% |
| Centivo Contracted [320505] | $5 | 158% |
| Providrs Care Network Contracted [320484] | $6 | 189% |
| Insurance System Inc Contracted [320465] | $9 | 284% |
| Benefit Management Contracted [320052] | $9 | 284% |
| Point C Contracted [320238] | $9 - $82 | 284% |
| Health Systems Inc Contracted [320174] | $9 | 284% |
| Healthscope Contracted [320182] | $9 - $82 | 284% |
| Show-Me Health Administrators Contracted [320483] | $19 | 599% |
| Mercy Benefit Admin Contracted [320251] | $19 - $77 | 599% |
| Imagine 360 Contracted [320494] | $77 | 2429% |
| Reflect Health Contracted [320492] | $77 | 2429% |
| Auxiant Contracted [320462] | $77 - $82 | 2429% |
| Ebms Contracted [320493] | $77 | 2429% |
| Yuzu Health Contracted [320521] | $77 | 2429% |
| American Healthcare Alliance Contracted [320020] | $77 | 2429% |
| Edison Health Solutions Contracted [320502] | $77 | 2429% |
| Aither Health Contracted [320449] | $77 | 2429% |
| Preferred Health Plan Contracted [320522] | $82 | 2587% |
| Federal Medical Center Contracted [320127] | $82 | 2587% |
| Healthlink Contracted [320179] | $82 | 2587% |
| Compcare Of The Ozarks Contracted [320437] | $87 | 2744% |
| Workers Comp [20426] | $88 | 2776% |
| Private Health Care Systems Contracted [320320] | $102 | 3218% |
| Multiplan [20270] | $104 | 3281% |
| Multiplan Contracted [320270] | $104 | 3281% |
Consumer Guidance & Cost Commentary
For the CPT code 81001, Urinalysis (automated, with microscopy), the gross charge at Mercy Specialty Hospital Southeast Kansas is $110.00. This facility is located in Galena, Kansas, and offers a cash price of $72.00, which is lower than the median negotiated rate of $6.00 reported across 51 payers. While the facility's cash rate is competitive, patients should be aware that commercial insurance negotiated rates can sometimes exceed cash prices; for instance, the highest negotiated amounts observed in the data reach $104.00. If you have a high-deductible plan, paying the cash price upfront may result in lower out-of-pocket costs compared to having insurance pay a higher negotiated rate, especially if your deductible has not yet been met.
To minimize costs, we recommend asking the hospital directly about "self-pay" or "prompt-pay" discounts before scheduling your appointment, as these upfront payment incentives can significantly reduce the final bill. Additionally, if you are using insurance, ensure you request an itemized bill to verify that all services are correctly coded and that no balance billing occurs, particularly for out-of-network ancillary services. For context on pricing fairness, the Medicare benchmark for this procedure is $3.17, which serves as a baseline for evaluating the facility's commercial rates. The facility's cash rate of $72.00 is notably higher than the Medicare amount, reflecting the administrative costs and profit margins inherent in commercial billing structures.